Dysrhythmogenic potential in acute admissions to psychiatric hospitals and clinics

Abstract:

Co-morbidity between physical disease, especially cardiovascular, and psychological disturbances is well documented. In psychiatric patients, the potential for dysrhythmogenic incidences is increased by the fact that many psychiatric medications influence cardiovascular function.
AIM: The aim of the study was to examine the dysrhythmogenic potential of 30 psychiatric patients (group A), irrespective of diagnoses or medication, at admission to psychiatric institutions.
METHODS: The dysrhythmogenic potential was determined in terms of heart rate-corrected QT intervals (QTc), heart rate-corrected JT intervals (JTc), QT and JT dispersion (QTcd and JTcd) between leads v1 and v6, and heart rate variability (HRV) as determined from lead v6 of the ECG. Values were compared with 30 age- and gender-matched controls (group B). In the second part of the study the dysrhythmogenic indicators were assessed in a patient group (group C; n 5 43) with only psychiatric disorders and compared to a group with psychiatric as well as medical disorders (group D; n 5 27).
RESULTS: The patient group A had significantly higher values than the control group for mean QTc (v6) (0.4579 + 0.0328 vs 0.4042 + 0.0326; p 5 0.0470), mean JTc (v6) (0.3883 + 0.0348 vs 0.3064 + 0.0271; p 5 0.0287) and mean QT and JT dispersion values (QTcd 5 0.0443 + 0.0203 vs 0.0039 + 0.0053 and JTcd 5 0.0546 + 0.1075 vs 0.0143 + 0.1450, p < 0.05). A statistically significant difference (p < 0.0001) was found between the patients' (group A) HRV and that of the controls (group B). No statistically significant differences were found between the values of the dysrhythmogenic indicators for patients with only psychiatric illness (group C) and those with psychiatric as well as medical disorders (group D).
CONCLUSIONS: Psychiatric patients at the point of admission to psychiatric institutions may have an increased dysrhythmogenic potential, not necessarily caused by physical disease. The potential of an augmented risk for cardiovascular incidents in psychiatric patients should be considered when treating such patients.